Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock*

Carcillo, Joseph A.; Fields, Alan I.

doi:10.1097/00003246-200206000-00040

Cited by 590 publications

(445 citation statements)

References 130 publications

Supporting

Mentioning

411

Contrasting

Unclassified

Order By: Relevance

“…Primary endpoint was the resolution of shock in either arm as determined by proportions attaining locally-adapted American College of Critical Care Medicine/Paediatric Advanced Life Support (ACCM/PALS) therapeutic (resuscitation) end points (here called resuscitation targets) at 8 hours [20,21]. Attainment of resuscitation targets was defined as the absence of all of the following features: severe tachycardia (>180 beats/minute if aged <12months, > 160 beats/minute if aged 1-5years or >140 beats/minute if aged ≥ 5 years); hypoxia (oxygen saturation <95%); hypotension: systolic blood pressure (SBP) (<70mmHg for <12 months and <80mmHg for > 1 year) or delayed capillary refill time (CRT) (≥3seconds).…”

Section: Discussionmentioning

confidence: 99%

Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria*

Akech

Jemutai

Timbwa

et al. 2010

Critical Care Medicine

View full text Add to dashboard Cite

Objective: A previous meta-analysis has shown a consistent survival benefit in children with severe malaria receiving human albumin solution (HAS) compared to other resuscitation fluids.HAS is expensive and not readily available in Africa. We examined the safety and efficacy of the fluid resuscitation with two synthetic colloids, Dextran 70 and hydroxyethyl starch to inform future trial design.Design: An open-label randomised controlled, phase II safety and efficacy trial. 23/37 (62%) and 25/39 (64%) respectively (p=0.99). Acidosis resolution and respiratory distress was marginally superior in HES group: 3/39 (8%) remained acidotic at 8 hours versus 10/37 (27%) in Dextran arm (p=0.05). There were 4 deaths (5%), two per arm; including 3 deaths in the coma subgroup (3/39, 8%). No other new adverse event was reported. Conclusions:Correction of shock by volume expansion with either Dextran or HES in children with severe malaria acidosis is safe with low mortality, including the highest risk cases admitted in coma. Both solutions present an attractive and practical option for consideration in future volume resuscitation trials in severe malaria.3

show abstract

Section: Discussionmentioning

confidence: 99%

Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria*

Akech

Jemutai

Timbwa

et al. 2010

Critical Care Medicine

View full text Add to dashboard Cite

show abstract

“…Severe disease was defined as a GMSPS of 8 or higher. Septic shock was defined as confirmed infection with clinical signs of decreased perfusion despite adequate volume replacement, and one or more signs of impaired perfusion (lactate >2 mmol/l, capillary refill greater than 2 s, base deficit >−5, decreased mental status or decreased urine output) [11,12]. Severe disease without septic shock refers to children with a GMSPS of 8 or higher but who did not have signs of septic shock.…”

Section: Methodsmentioning

confidence: 99%

A predominantly anti-inflammatory cytokine profile is associated with disease severity in meningococcal sepsis

et al. 2005

View full text Add to dashboard Cite

Objective-This study aimed to determine whether an anti-inflammatory profile in meningococcal disease is associated with an increased risk of severe disease or septic shock.Design and setting-Prospective observational study in a tertiary care children's hospital. Patients and participants-63 children with confirmed meningococcal disease.Interventions-Plasma concentrations of interleukin-1 receptor antagonist (IL-1Ra), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumour necrosis factor-α (TNF) were assayed on admission. Receiver operator characteristic curve analysis was used to determine optimum thresholds for IL-1Ra:TNF, IL-1Ra:IL-6 and IL-1Ra:IL-8 ratios.Measurements and results-Median IL-1Ra:TNF and IL-1Ra:IL-6 ratios were significantly higher in severe disease with septic shock than in severe disease without septic shock and in non severe disease (IL-1Ra:TNF 263 vs. 185 vs. 108; IL-1Ra:IL-6 139 vs. 23 vs. 17). Median IL-1Ra:IL-8 ratios were not significantly different in the three groups. A significantly larger proportion of children with high IL-1Ra:TNF-α and IL-1Ra:IL-6 ratios developed severe disease with septic shock than those with a low ratios (95.2% vs. 4.8%; 76.2% vs. 23 .8%).Conclusions-An anti-inflammatory profile appears to be associated with the development of severe disease and septic shock in meningococcal sepsis. This may imply that experimental new therapies of pro-inflammatory cytokine inhibition and anti-inflammatory cytokines in meningococcal disease could be detrimental.

show abstract

“…Sin embargo, si persiste el shock, su respuesta hemodinámica es distinta a la descrita en adultos caracterizándose por un bajo gasto cardíaco (GC), hipodébito y elevada resistencia vascular, de manera que es la disponibilidad de oxígeno (oxygen delivery, DO 2 ) y no su extracción (oxygen consumption, [VO 2 ]/DO 2 ), el principal determinante del consumo de oxí-geno. Aproximadamente el 50% de los niños presentan este patrón hemodinámico el cual es conocido como SS frío [6][7][8] .…”

Section: Diferencias Del Shock Séptico En Población Infantil Y Adultaunclassified

Shock séptico en pediatría II: Enfoque actual en el diagnóstico y tratamiento

et al. 2013

Rev. chil. pediatr.

View full text Add to dashboard Cite

Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock*

Cited by 590 publications

References 130 publications

Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria*

Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria*

A predominantly anti-inflammatory cytokine profile is associated with disease severity in meningococcal sepsis

Shock séptico en pediatría II: Enfoque actual en el diagnóstico y tratamiento

Contact Info

Product

Resources

About